Cardio part 1 Flashcards

Question

Typical sx of atrial flutter

Answer 1

Palpitations Fatigue or poor exercise tolerance Mild dyspnea Presyncope

Answer 2

Angina Profound dyspnea Syncope

Answer 3

``` EKG Vagal maneuvers if flutter waves are not seen Adenosine Exercise testing TTE ```

Answer 4

CCBs or BBs for rate control May need cardioversion Anticoagulation Consider radiofrequency ablation

Answer 5

``` Triggered by a reentry mechanism Premature atrial or ventricular ectopic beats Other triggers: -Hyperthyroidism -Stimulants -Alcohol ```

Answer 6

``` Toxins Thromboses Temperature Tension pneumo Tamponade Trauma Hypoxia Hypovolemia Hypokalemia/hyperkalemia Hydrogen ```

Answer 7

``` Palpitations Dizziness SOB Syncope CP Fatigue Diaphoresis Nausea ```

Answer 8

``` Cardiac enzymes Electrolyte levels CBC Thyroid studies Digoxin level Electrophysiologic studies EKG CXR TTE ```

Answer 9

Hypotensive or unstable: immediate cardioversion | Stable: try vagal maneuvers, then if unsuccessful, adenosine

Answer 10

Caused by electrical reentry or abnormal automaticity

Answer 11

``` Ischemic heart dz Structural heart dz with disruption of nl conduction patterns Congenital structural cardiac d/os Acquired channelopathies Inherited channelopathies Electrolyte imbalances Sympathomimetic agents Digitalis toxicity Systemic diseases causing infiltrative cardiomyopathy or scar ```

Answer 12

``` Palpitation Lightheadedness Syncope CP Can also be asymptomatic ```

Answer 13

``` Hypotension Tachypnea Diminished LOC Pallor Diaphoresis High JVP Mental status changes: Anxiety Agitation Lethargy Coma ```

Answer 14

Electrolytes Serum levels of therapeutic drugs Toxicology Serum cardiac markers

Answer 15

Echo EKG Holter monitoring with recurrent syncope or palpitations

Answer 16

VT associated with loss of consciousness or hypotension needs immediate cardioversion with 100-200J biphasic Address reversible RFs Lidocaine if pts have ongoing myocardial ischemia Pulseless VT- high-dose unsynchronized energy

Answer 17

Referral to a cardiologist Admission to a monitored bed Further studies, such as electrophysiologic study Consideration for radiofrequency ablation Consideration for ICD placement

Answer 18

Depends on cause: Amiodarone in combo with BBs for pts with left ventricular dysunction d/t previous MI Heart failure: BB, ACE, aldosterone antagonists Stains for coronary heart disease

Answer 19

Most often associated with CAD Can result from AMI or ischemia or from myocardial scarring from an old infarct VTach can aslo degenerated into VFib Reentrant patterns break up into multiple smaller wavelets and the level of disorganization increases, with reentrant circuits producing high-frequency activation of cardiac muscle fibers

Answer 20

``` Acute and chronic ischemic heart disease Valvular disease Congenital structural heart disease Paroxysmal VFib or short-coupled torsades Idiopathic VFib and VTach PE Aortic dissection Electronic control devices Nonstructural abnormalities Catecholaminergic polymorphic VTach WPW syndrome Brugada syndrome ```

Answer 21

Pts at risk may have prodromes of CP, fatigue, palpitations, and other nonspecific complaints, but many are asymptomatic

Answer 22

Hx of left ventricular dysfunction

Answer 23

``` CAD Previous cardiac arrest Syncope or near-syncope Prior MI, esp within 6 mos LVEF <30-35% H/o frequent ventricular ectopy Drop in SBP or ventricular ectopy upon stress testing, particularly when associated with acute myocardial ischemia Dilated cardiomyopathy from any cause HCM Use of inotropic meds Valvular heart disease Myocarditis ```

Answer 24

Antiarrhythmic drug administration Hypoxia Ischemia Atrial fibrillation with very rapid ventricular rates in the presence of preexcitation Electric shock administered during cardioversion Electric shock caused by accidental contact with improperly ground equipment Competitive ventricular pacing to terminate VTach

Answer 25

``` Confirm only with EKG Echo Nuclear imaging for assessment of pts at risk Labs: 'lytes, including calcium and magnesium Cardiac enzymes CBC ABG Quantitative drug levels Tox screens and levels TSH BNP ```

Answer 26

Defibrillation Postresuscitation: Admit to ICU with close monitoring Assess for complications and establish the need for emergent interventions Mild therapeutic hypothermia BBs Thorough diagnostic testing to establish underlying etiology

Answer 27

AV bypass tracts Bundle branch block ventricular tachycardia Right ventricular outflow tract tachycardia Idiopathic left ventricular tachycardia Idiopathic VFib Rare forms of automatic focal VTach Scar-related VTach due to ischemic or nonischemic myopathy